Comment

21.03.18

A digital future must be a human future

Dean Royles, director of human resources and organisational development at Leeds Teaching Hospitals NHS Trust, argues that there are three things we can do now to boost workforce productivity through digital innovation.

It’s strategic planning time in the NHS. New operational guidance has been published. We know we will see an increase in demand, additional targets along with continued financial constraint. Same old, same old?

The NHS is being incentivised to move to more integrated working. Accountable care organisations make way for integrated care systems; sustainability and transformation funds are replaced by provider sustainability funds.

But it’s more than just a change of acronyms. It is an annual opportunity for reflection and renewal. We moan a bit about new guidance, we influence, we contextualise and we plan. Despite all the pressures the NHS has been under this winter, again, austerity has honed NHS planning skills and, perhaps surprisingly for many, has increased NHS productivity. 

NHS England board papers report NHS productivity growth has been rising at 1.7% each year, outstripping productivity in the wider UK economy. Many, however, understandably argue this is unsustainable productivity, achieved by ‘sweating the asset.’ That asset in the NHS is staff, and productivity gains won this way will inevitably be at the deterioration of morale and motivation along with higher turnover, less discretionary effort and a poorer quality of service. Safety becomes compromised.

Productivity is the major workforce challenge for the next few years, and yet it is not getting the national coverage it deserves. The workforce debate is dominated by Brexit at the strategic planning seminars and events I have attended. Don’t get me wrong, this is hugely important subject, especially if you are one of the thousands of EU staff feeling uncertain about the future. And lots is happening to try to mitigate this: national discussions on migration caps, reassurance for EU national about their future, networks, coalitions, monitoring and central returns. All good, necessary, reassuring actions.  

However, from a strategic workforce perspective, artificial intelligence, robotics, genomics, augmented reality, digital advances leading to increased point of care testing, and more rapid diagnostics will all have an enormous impact on how the NHS works, and capitalising on this is the only way we can sustain productivity growth. We don’t just need an emphasis on digital innovation – we need a relentless focus on what this innovation means for the way we work.

It is promising that the NHS is establishing a Digital Academy to engage digital leaders, but we also need to engage HR directors in what this era means for the way we work. We need as much focus on the implementation of digital innovation for the workforce as we have put into understanding the implications of Brexit on the NHS. 

I believe there are three things we can do now:

  1. HR directors and informatics directors to forge a new executive partnership: In the States they refer to the executive corridor as the ‘c’ suite. Much has been written about the importance of strategic alliances between ‘c’ suite executives. However, as the NHS sees the growth in digital leaders, with more occupying director and executive director positions in their own right, it seems that the HR director and the chief digital officer should be a very visible, very effective alliance. If we can maximise the interrelation of the two biggest enablers in the organisation – people and technology – we start to jump the curve on sustainable productivity gain;
  2. Productivity will be led through support staff: High-quality healthcare is about teamwork. It is hard to envisage how individual staff become more productive. Unless someone invents a virtual bed, we will still need a safe ratio of registered nurses and support staff looking after patients on a ward. Lengths of stay and readmission rates may improve through technology, but real productivity is about the way the whole organisation works. Innovation in robotics and artificial intelligence is going to be embedded through improving the way diagnostics, support and administration work. We can help these staff lead this change by ensuring the benefits of technology improve the quality and satisfaction of their work, not just work intensity;
  3. Drive this agenda centrally as an HR and people issue, not just a technical challenge: By far the most important challenge is to ensure that individual NHS organisations and system regulators act to ensure the alignment of the digital agenda and the HR agenda. There is no credible medium-term workforce strategy without a digital strategy, and there is no digital, paperless future in the NHS without a people strategy. Amara’s Law is very pertinent at this time in the NHS. He said that “we tend to overestimate the effect of technology in the short run and underestimate the effect on the long run.”

If we are to improve productivity in a sustainable way, we can’t underestimate the effect the digital era will have on the way we work.

Digital Innovation

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